Case Study
The NHS Widening Digital Participation programme (United Kingdom)
Challenge
With the continuing shift towards digital by default and digital-first services throughout the
health care system in the United Kingdom, there is a risk for growing health inequalities in the
country. Overlap between groups who are digitally excluded and those at risk of poor health is
significant, with clear correlation, for example, between the socioeconomic status of a ward area
and the levels of basic digital skills of its inhabitants and their average life expectancy.
Marginalized and vulnerable groups tend to be more digitally excluded and in worse health. With
12.6 million people in the United Kingdom lacking basic digital skills, and 5.3 million having
never been online, the health inequalities already experienced by these groups may become more
pronounced as health services increasingly require higher levels of digital health literacy for
navigation.
Action
The NHS Widening Digital Participation programme (September 2013 to March 2016) was
intended to improve the digital skills and digital health literacy of groups most affected by health
inequalities to allow them to take charge of their own health. These include those who were
unemployed, disabled, in receipt of benefits or living in social housing; minority groups (Black,
Asian, other ethnicities), refugees and asylum seekers, gypsies and travellers; and those learning
to speak English as a second language. Over the three years of the project, more than 387 000
people were reached to help them to manage their health with digital tools and resources, and
more than 221 000 people trained to use digital health resources. Furthermore, 8000 volunteers
were trained to promote awareness and use of digital resources.
Results
The improved digital health literacy skills and confidence gained by those supported through the
programme led to direct impacts on their behaviour, resulting in changes in lifestyle and/or the
way they engaged with health services. Learner achievements included accessing health
information online for the first time, going online to find health services, booking general
practitioner appointments, ordering repeat prescriptions, using the Internet and sites such as NHS
Choices to search for non-urgent medical advice, and using the Internet to look up information
on health conditions and tips for staying healthy. Such behaviour changes have resulted in
significant cost savings for the National Health Service in the United Kingdom. Evaluation of the
programme found total annual potential savings of £6 million (€6.6 million) from reduced visits
to general practitioners (£3.7 million) and accident and emergency departments (£2.3 million).
Other positive outcomes included learners reporting feeling less isolated or lonely and feeling
more self-confident as a result of learning digital skills, as well as feeling that they were more
informed about their health and were more confident using online tools to manage their health,
including exploring ways to improve mental health and well-being.
Case Study adapted from:
World Health Organization [WHO]. (2018). Health promotion for improved refugee and migrant
health: Technical guidance. Copenhagen: WHO Regional Office for Europe.